Obamacare effect has started.

In precisely the kind of news president Obama does not want heading into the election, Ford (F), Dow Chemical (DOW), DuPont (DD), and Advanced Micro Devices (AMD) all announced mass layoffs this past week as Firings Reach Highest Since 2010.

Firing Details

Ford is closing its first European car-assembly factories in 10 years
AMD, the second-largest maker of processors for personal computers, said last week it will cut 15 percent of its staff, or about 1,665 jobs, after forecasting fourth-quarter sales that fell short of analysts’ estimates.
Dow Chemical will close 20 plants in the U.S. and abroad to eliminate about 2,400 jobs
DuPont plans to trim 1,500 jobs after third-quarter profit trailed analysts’ estimates
Cummins Inc. (CMI), a Columbus, Indiana-based engine maker, said it expects to erase as many as 1,500 jobs by the end of 2012 and lowered its forecasts for sales and profit.
Kimberly-Clark Corp. (KMB) said this week it plans to cut manufacturing and administrative operations as it exits the diaper business in western and central Europe

What’s the Impact on Unemployment?

In isolation, one would expect the unemployment rate to rise. However, Obamacare is having some peculiar effects on number of hours part-timers can work, which in turn led to a spur in hiring.

For details, please see Obama Slashes Four Hours Off Definition of “Full-Time” Employment.

Seven Forces at Play

Obamacare reduced the number of hours part-timers can work, thus increasing the need for more workers.
Seasonal hiring may have been early this year because of Obamacare, skewing the latest job results. Thus part of the recent rise in hiring will likely be revised away
The global slowdown reduces the need for workers
To combat the contraction in earnings corporations are firing workers, thus the recent mass layoff announcements
Companies are also worried about the fiscal cliff and its effect on consumer purchases. The reality is a fiscal cliff is needed and will occur at some point anyway, but no one wants to address the budget now.
Forced Retirement
Disability Fraud

Once the Obamacare effect plays out (perhaps in a month, perhaps it already has), the net effect of the first five forces is for the unemployment rate to rise.

However, we still have the issue of “forced retirement” which I describe as people who want a job and need a job but are of retirement age and decide to collect Social Security just to have some money coming in.

Forced retirement causes a drop in participation rate, artificially lowering the unemployment rate. Disability Fraud does the same thing.

The United States was suffering from a crisis in health care when President Barack Obama came into office. As a result of the deindustrialization of the U.S. economy, the privatization of health care into profit-making ventures, and deregulation, both the health care system and the health of the American population was rapidly deteriorating.
Obama’s health care program, however, has made the situation much worse. If allowed to continue, it will turn the U.S. government into the enforcer of a worse-than-Hitler genocide machine.
In other locations, EIR has provided in-depth examination of the Nazi premises behind what is called Obamacare. Here we restrict ourselves to a presentation of crucial facts which show that such Nazi measures are already underway and leading toward mass death.
– I. PROVENANCE—HITLER’S T4 –

1. HITLER T4 HEALTH CARE. In October 1939, Adolf Hitler issued his official directive on selectively putting people to death, which was already underway in Germany on handicapped children and concentration camp inmates. It was titled, “The Destruction of Lives Unworthy of Life.” It arose from a prior meeting he held with medical professionals, to review “criteria” for practical and cheap methods of removing people, deemed to be “unrehabilitable” and thus burdens on the nation.
Hitler’s directive was administered out of headquarters in Berlin at No. 4 Tiergarten Strasse, where the Reich Work Group of Sanatoria and Nursing Homes, began by conducting surveys of patients nationwide, designating who was not worthy to continue to live. They were put to death; the principle involved came to be applied on a mass scale through the gas ovens at concentration camps.
2. TONY BLAIR T4 HEALTH CARE. In Britain, on April 1, 1999, the first initiative was taken by the Tony Blair government (1997-2007) in the name of health care “reform,” to institute an updated version of the Hitler T4 program: the National Institute for Health and Clinical Excellence (NICE) was formed, to dictate what treatments would, and would not, be given to designated groups of patients in the British National Health Services (NHS), which had served the nation since the 1940s.
Blair’s health adviser to set up NICE, Simon Stevens, then moved to takedown the NHS system, by privatizing key functions, in particular through the private insurer UnitedHealth Group UK, which Stevens joined.
The record shows how the death rate has climbed for whole classes of Britons, especially the elderly and cancer patients, as a result of both NICE barring treatments, and the NHS being dismantled. For example, as of 10 years after NICE went into effect, only 40 to 48% of British men diagnosed with cancer survived, and 48 to 54% of British women; in stark contrast to Sweden, for example, where 60% of men and 61% of women survived after a cancer diagnosis.
A particular program to speed up death was put into effect called the Liverpool Care Pathway for the Dying Patient (LCP). According to extensive exposes in the British press, over the 2000s, participating NHS hospitals were offered financial inducements to put patients deemed as at the end-of-life, on the LPC list, under which all treatment is discontinued, and even water and hygiene removed. The LCP started originally for cancer patients in Liverpool in the 1990s, with royal patronage; by 2012, it involved 178 NHS hospitals throughout Britain, and involved patients with any illness. On average, 130,000 persons a year were put under LCP, under the claim of saving medical resources, which as of 2012, had rewarded hospitals with at least $40 millions. An estimated 60,000 on LPC died yearly, without having given their consent to discontinue care. After storms of protest, the U.K. government in July 2013, ordered the LCP to be phased out over the next 12 months.
3. OBAMA T4 HEALTH CARE. In 2009, the Tony Blair/Hitler health concept was launched in the United States, by the new Obama presidency, as a campaign under the euphemism of care “reform,” just as Tony Blair had done in Britain. The Obama drive culminated in the March 23, 2010 Patient Protection and Affordable Care Act. Leading up to this were 18 months of intense propaganda, including 30 hearings and round-tables, under the cynical slogan that, under Obamacare, all Americans will get “access to care” through access to insurance.
In reality, the ACA law is made up of sets of measures to accomplish deliberate cuts in care, the destruction of the means to deliver it, and to perpetrate death. At the same time, private Wall Street insurers get Federal subsidies.
Key figures in bringing about the ACA—including several with direct involvement in imposing this on the British health system— have explicitly expressed the T4 principle, that there are “lives not worthy” to continue.
Dr. Ezekiel Emanuel, a longtime advocate for this Hitler health view, was appointed by Obama, in early 2009, as the health adviser to the Office of Management and Budget. In April, 2009, he was put on the new Federal Coordinating Council on Comparative Effectiveness Research, to devise rationalizations for cutting medical treatment. In particular, Emanuel stressed that the Hippocratic Oath caused “over-use” of medical resources, which must stop.
Peter Orszag, Obama’s first head of the Office of Management and Budget, promoted the panoply of Hitler health arguments and mechanisms. He is considered the leading architect of the Independent Payment Advisory Board (IPAB)—the analogue to NICE, called the death panel. He advocates cost-benefit analysis to justify whether medical treatment is warranted for a person. He backs the statistical “Quality Adjusted Life Years” (QALY) metric for whether it is worth it for a person to continue to live. Orszag’s London collaborator, Sir Michael Rawlins, head of NICE, pumped the QALY formula, in a Time interview March 27, 2009, saying, “A QALY scores your health on a scale from zero to one: zero if you’re dead, and one if you’re in perfect health. You found out, as a result of a treatment, where a patient would move up the scale…” and you decide, based on how much a year of life is worth, whether to permit it or not, if it takes too much away from society’s scarce resources.
Moreover, Orszag holds that, even if you are not sick, but are living “excessively long,” he advises that you should have your Social Security “adjusted” (i.e. reduced), according to a statistical formula he backs, called the “Longevity Index.”
Simon Stevens, Tony Blair’s Hitler health operative, who re-located from the U.K. to the United States in 2007, personally advised the Obama White House, on what to set up in the new health law. In May 2009, he presented a report titled, “Reducing Avoidable and Inappropriate Care,” saying that $520 billion can be “saved” in the first 10 years of a new reform act, by cutting services to non-worthy people, especially the old. Stevens is the Medicare expert at UnitedHealth Group, the largest health insurance HMO in the United States (70 million policies).
Sir Donald M. Berwick, knighted by Queen Elizabeth, for his work on NICE and “reforming” the British National Health Service, to cut out excessive lives, was given a recess appointment by Obama on July 7, 2010, to be Administrator of the Centers for Medicare and Medicaid Services (CMS). As such, he was responsible for initiating T4 policies in programs affecting 49 million older Americans in Medicare, and 48 million poor, disabled and dependent, in Medicaid. He stayed in office as long as his recess-appointment tenure would allow, leaving in December 2011, to avoid the scrutiny that would ensue in the Senate from a proper nomination to CMS head.
While in office, he moved to strike certain cancer drugs from approved Medicare reimbursement; to set up ways to financial penalize hospitals for “over-treating” patients; and limit physicians by financial penalties and pushing top-down “evidence-based” medical practice dictates. He was followed in office by Marilyn Tavenner, a technocrat for Obamacare, with a pedigree as top executive at HCA, the mega for-profit hospital chain, benefitting from the takedown of the traditional community hospital system.
– II. CONTEXT—POVERTY; ILLNESS; –

– HOSPITAL SYSTEM DEGRADED –

The ACA measures are being imposed as the final health care “solution” to the poverty, illness, and suffering already underway as of 2010, and now far worse.

1. IMPOVERISHMENT. Of the U.S. population of 314 million, roughly 135 million are working, but 20 million are working only part-time, and more than 50 million (inclusive of most of the 20 million) have work defined as low-wage (twice poverty line or lower). 52 million people are in households defined as poor ($22,000 or less income for a family of four); this is the highest ever. The number of people living in “deep poverty,” represented by an impossible $11,000 annual income for that family of four, has jumped to 20 million—one in 15 Americans.
Some 50 million must use food stamps; and 50-80% of public school students in 20 southern and western states are poor, and rely on discount and free meals through the school-lunch programs of the Agriculture Department.
In the official jobless picture: 11.8 million Americans are unemployed; 8.8 million are forced to work part-time; 4.5 million eligible workers have left the labor force or, coming of age, never entered it. This is 25 million eligible workers who need but do not have full-time work.
Due to actual inflation as defined by major categories of the market basket of living, in government statistics, the lower-income 60% of the population has experienced a drop of 10-15% in its real income since 1999. The fourth quintile has somewhat more than broken even and the top 20%’s real income has doubled. Another measure of this for the lower 60%; their actual average income is $500 more per household than in 1999; their actual expenses of living are $5,000 more.
The ratio of the total population employed is at 4-decade low, 52.4%. For young people aged 18-34, the ratio of employed has fallen from 84% in 2000 to 72% in 2012.
But if one abstracts from self-employment, and takes Americans employed full-time by an employer not themselves, that ratio is down to 43.4%. According to Gallup, which surveys it, it has fallen by 5.0% since 2010, a tremendous drop.
As to “saved” wealth (mainly houses), more than 90% of the households in the country have less wealth than they had in 2008.

2. DESPERATION—SUICIDE RATE. The U.S. suicide rate has skyrocketed. The rate at which Americans between 50 and 64 years of age kill themselves, rose 45% between 1999 and 2010, according to the Centers for Disease Control and Prevention (CDC). Women aged 60 to 64 had a rise of 60%; and men in their fifties, had a rise of 48%. The CDC researchers point out that these age cohorts of citizens are being squeezed under impossible pressures of lack of means to care for themselves, their elderly parents, and their own children, also hit by economic crisis.

3. DISEASE, DEATH RATES RISING. Sickness and mortality rates are increasing for cohorts of the population, who are poor, jobless and with no future. Many illnesses are associated with increased accident rates, obesity, malnutrition, parasites, drug and alcohol abuse, and other factors of despair, plus lack of medical treatment.
Add to this, the increased diseases associated with globalization and decline in public health services.
The CDC in September sounded the alarm about the increase in drug-resistant bacteria, in a 114-page report, Antibiotic Resistance Threats in the United States 2013, giving particulars for 18 microbes. Two million Americans—at the very least—are affected by one or more of the prevalent microbes each year, with at least 23,000 deaths from the infection.
Consider food-associated illnesses. 48 million Americans—one in six—are sickened each year from food-borne illnesses; 128,000 are hospitalized and 3,000 die, as reported by the CDC. A high percentage of the microbes come in food imports, which now supply 15% of U.S. food consumption overall, and much higher percentages for particular types, e.g. seafood (85%).
Overall, even crude vital statistics for the county level, show that U.S. life expectancy is declining for millions of Americans. The July 10 issue of the Journal of the American Medical Association ran coverage titled, “The State of U.S. Health”, showing that in 1,405 counties (mostly in the South, Western tribal lands, and Appalachia)—which is 45% of the total number of 3,014 counties in all 50 states—female life expectancy remained static, or declined from 1985 to 2010. In 72 of these counties, the decline was very significant—over two years or more. The same for men in poor counties. If you were born a male in McDowell County, West Virginia, in 2010, your life expectancy is 63.9 years. (The analysis covers all counties; and a set of 291 diseases. See http://www.healthmetricsandevaluation.org/)

4. SAFETY NETS FAIL—MEDICAID. There are now more than 51.5 million Americans on Medicaid, the Federal program—run in conjunction with states—enacted in 1965, as a safety net to see that people out of means for necessities—temporarily or for reasons beyond their control—have medical care. Moreover, this roster of one in six Americans being so poor as to qualify for medical care, does NOT represent the extent of low-income persons who need help, because in recent years, most state governments have imposed ever-stricter enrollment requirements, to try to keep down the numbers. Over the last 10 years, Medicaid expenditures overall grew 90%, and became in many states, the foremost budget category.
Instead of seeing this as the reflection of the economic collapse, many Congressional delegations express their version of Hitler’s health care, by opposing not only Obamacare, but also demanding cuts to Medicaid, in order to “cut the deficit” by cutting lives.

5. HOSPITAL SYSTEM DISMANTLED. Over the past 40 years of worsening economic conditions, the nationwide system of hospitals, which had been built up since the 1946 Hill-Burton Act (Hospital Survey and Construction Law), has been drastically dismantled. The advent of HMOs after the enabling act of 1973, and further deregulation allowing the predation by for-profit Wall Street hospital chains, to take over or shut down non-profit local hospitals, drove the takedown.
As of 1980, when the ratios of standard care (hospital beds and physicians per 100,000 persons) was the best, there were 5,810 community hospitals, spread over 3,000 counties, which provided 987,000 beds for 226 million people. But by 2011, the number of hospitals dropped 15%, down by 837 to below 5,000. The number of beds dropped by 20%, down by 189,000, to 798,000. Yet there were 85 million more people to care for. The national average bed-to-population ratio fell from 4.4 per 1,000 people in 1980, down to 2.6 per 1,000 in 2011, a 41% drop.
In the course of this, waves of local, non-profit community hospitals have been taken over, scaled down, or shut, in the process of a few mega-chains—many of them for-profit—coming to dominate hospital care. This is another aspect of Wall Street. The hospital chains—six of the biggest are publicly traded—are positioning on how to profiteer, in the new corporatist/government ACA world.

6. PUBLIC HEALTH TAKEDOWN. Vital public health services by the Federal government, states and localities—from pest eradication, to food safety monitoring—have been cut back drastically in the last few years, under attempts at cutting government functions to try to “balance the budget” on Wall Street terms.
For example, federal aid has dropped for the Centers for Disease Control and Prevention’s division, Epidemiology and Laboratory Capacity for Infectious Disease, down from around $35 million yearly in the early 200s, down to $10 million by 2012. Among many other things, this is the agency supplying resources for fighting mosquito-borne diseases, such as West Nile Fever, which surged back this Summer.
– III. OBAMACARE KILLER MEASURES –

1. SHUT DOWN HOSPITALS. The U.S. hospital-centered health care system, already contracting, is now under assault from multiple Obamacare measures.
Overall, Obamacare identifies cuts of $716 billion over 10 years in cuts to Medicare, as well as cuts in other programs. Much of this directly and indirectly hits hospitals.

* Penalize readmissions. Financial penalties against hospitals are in effect for their too-frequent re-admission of sick patients. Since October 2012, hospital rates of re-admission are reported quarterly and evaluated. A rate considered too high results in docking Medicare payments to the hospital. The cut is up to 1% in FY 2013; up to 2% the next year; and 3% thereafter.
On Sept. 30, 2013, the end of the first year of the ACA Hospital Readmissions Reduction Program (HRRP), 2,225 hospitals were penalized a total of $227 million, according to Kaiser Health news.
The intent was clear right from the state. As of the first quarter of the program, of the 3,282 hospitals in the HRRP, fully 66.7%, or 2,189 facilities suffered a cut in Medicare payments. Teaching hospitals, which tend to have complex cases of elderly patients, and safety-net hospitals serving the poor, predictably have the most need for re-admissions, and they are reeling from the cuts. HRRP will cut Medicare spending by $8.2 billion from 2013 to 2019, say Obamacare statisticians.

* Cut charity care. Obamacare specifies cuts in Federal aid to hospitals, which has defrayed costs of treating the uninsured poor. Starting in 2014, Obamacare will cut what is called DSP—Disproportionate Share Payments. The hospitals are to get $22 billion less over the current 10 year period, according to the American Association of Medical Colleges and the Commonwealth Fund.

* Sequester cuts. Some $95 billion in other cuts in Medicare programs, are underway, including the impact of the sequester, all of which are slamming hospitals, according to Caroline Steinberg, vice president for analysis at the American Hospital Association. In fact, a specific sequestration automatic cut has taken away $45 billion from hospitals—more than double what the Obamacare DSP charity cut was.

* Mass threat to rural hospitals. In August, 2013, the Obama Administration proposed a rule change to what is called the Critical Access Hospital (CAH) program, which would shut down hospitals in rural areas en masse. There are currently 1,332 CAH hospitals nationwide, with potentially two-thirds in line for shut down. The CAH system was set up in 199x, to act to curb closures of rural hospitals.

The way it has worked prior to the Obama proposed change, is that, under the CAH system, since 2006, state health officials designate which of their community hospitals—often in low population density areas—are critical to remain open and viable in their localities, in order to provide residents, in particular the Medicare age bracket, the physical means to receive care. The criteria include that the facility not have more than 25 beds, it be at least 35 miles distant from other hospitals, and other rubrics. These CAH facilities then get reimbursed by the Federal CMS (Center for Medicare and Medicaid Services) at 101% for their Medicare-related expenses, not at any lower Medicare reimbursement rates.
But in August, Inspector General Daniel Levinson, for the Health and Human Services (DHS) Department, issued a report declaring that hundreds of these CAH hospitals no longer meet the criteria. So states should no longer have the right to designate CAH facilities; the HHS/CMS should henceforth do so, and they will disqualify many such hospitals from adequate reimbursement. This will financially ruin hundreds of rural hospitals, and cut access to care for millions of people, whether or not they may have health “insurance.” Particularly vulnerable are Iowa, with 82, and Kansas with 83 CAH hospitals.
2. DRIVE OUT DOCTORS. Under various Obamacare measures, physicians are under financial pressure and subjective coercion to acquiesce to the intent of the ACA to cut care and lives. To begin with, two-thirds of the doctors in the United States no longer practice medicine independently, but they are now in the employ of other entities—groups and hospital systems, to the point where the American Medical Association, in November, 2012, issued guidelines on how to cope with the “conflict of interest” involved—namely, where the physician wants to treat his patient according to the Hippocratic Oath, and the Obamacare system does not.
Only 36% of all U.S. practicing physicians own their own practice (in whole or in part), which is way down from 57% in 2000; and way below 85% or higher in the 1960s.
Rural areas are desperate for physicians, and the threat to shut down Critical Access Hospitals is a threat to cut off all advanced care in these localities, in particular in the farm states, where counties have a high percent of elderly.

PHYSICIAN VALUE BASED MODIFIER This program mandates that all doctors who see Medicare patients, as of 2017, will be paid by the CMS on a new basis of Federal judgment of the “quality” of their “performance,” instead of being paid according to the traditional reimbursement for actual treatment administered to patients—the examination, procedures, tests, etc. Physicians who are classified as “over-treating” will be financially penalized. There a “bonus” system for doctors considered compliant. Obamacare foresees having 500,000 doctors now working in group practice, under this program by 2017..
The system is being implemented in phases, according to what the Obama Administration announced in July, 2013:
Starting in 2015, group practices of 100 or more health professionals (doctors, nurses, technicians, social workers, etc.) will gain or lose up to 1% of their pay, depending on their rating. This will rise to 2% the following year.
Starting in 2016, mid-size physician groups (10 to 99 health professionals). They will be offered 2% bonuses, and the first-year free of penalties, to ease into the system.
Starting in 2017, the remaining physicians, in practices of 9 or fewer health professionals, will be phased in. the CMS estimates this will bring in 350,000.
A whole system of “quality” measures is pending, to rate doctors, with differing factors for each specialty. All physicians and health staff will have to file reports on every case, which in itself, will be an impossible burden for all but the large-scale practices now taking over what’s left of doctoring.
There is already an acute shortage of primary physicians everywhere, and certain specialties (obstetrics and orthopoedic) from region-to-region. In the District of Columbia itself, out of 8,000 physicians licensed to work in the capital, only 453 of them are primary-care doctors, who see patients more than 20 hours a week, according to a September, 2013 report by the D.C. Board of Medicine.
3. CUT DIAGNOSTICS. Screenings and diagnostics for diseases and conditions, and the staff and facilities to conduct them, are being denied and reduced under Obamacare. One of the methods, is the issuance of guidelines to cutback on preventive screening, by the U.S. Preventive Services Task Force (USPSTF), a pre-existing agency in the Department of Health and Human Services. Private insurers, accordingly, move to implement the new restrictions. Just two examples show the thinking.
* Breast cancer. Within three months of the enactment of Obamacare, new guidelines were, that women should get less frequent mammograms. This decree was made, despite the national concern for the fact that mammography use was already declining in the 2000s, mammography facilities were decreasing, and doctors feared a rise of breast cancer mortality rates. As of 2009, 27% of U.S. counties had no mammography facilities at all, a pattern associated with poor and rural areas.
In May, 2010, the U.S. Preventive Services Task Force stated that screening mammography for women aged 50 to 74 should be every two years, not yearly; and for younger and older women, such screening should be less often, and decided on an “individual” basis only.
This went directly against the modern standard, recommended by cancer specialists, for women to have annual screenings age 50 and above; and every two years for those 40 to 49.
Since the USPSTF decree, preventive mammography rates in women in their 40s have dropped nearly 6%, as of 2012. (Mayo Clinic study).
* Upper age limits on screenings? The Task Force is considering an upper age limit for screening mammography. In The Netherlands, women over 75 are not prohibited from mammograms, but they are no longer reminded to do it, despite the fact that breast cancer for elderly women is still a clinical concern, and treatment can extend their lives.
* Prostate cancer. In May, 2012, the Task Force recommended against prostate-specific antigen (PSA)-based screening for prostate cancer.
4. MAKE MEDICINES SCARCE. Obamacare, which empowers Big Pharma to effectively run the health system, has also given them virtual carte blanche over drugs. At present, it is presiding over a fast-worsening situation of medication shortages. This involves cancer drugs, sterile injectibles, certain anti-biotics, and many other basics. For example, in recent months, the frontline drug for tuberculosis, INH (isoniazid), has been scarce.
This is the characteristic, not the exception, under the ACA. As of July, 2013, supplies were short for 302 drugs, which is up from 211, same time in 2012.

5. CUTS TO HOME HEALTH CARE. CMS has issued plans to cutback many Medicare programs, for example home health care. There will be $100 billion in cuts over 10 years to home health care, from the combined impact of new CMS proposals and cuts already under way. Nationally, 3.5 million seniors are lined up for a 14% reduction in Medicare home health payments, potentially losing the skilled services on which they depend to live at home. The entire nationwide system of home-health agencies is jeopardized by what CMS Administrator Tavenner calls, her new plan to “re-base”the rates used to calculate funding for payments for home health care.

6. BASIC RESEARCH STARVED OUT. Funding for public medical research has fallen 20% in the last 10 years to the National Institutes of Health. This holds throughout the nation, at Federal, state and private centers, such as those working with the CDC. In particular, the pipeline is running dry for ways to treat drug-resistant microbes.
Instead, the priorities and grants for studies are concentrated in the control of Wall Street networks, through the Bill & Melinda Gates Foundation and the like. For example, the Weill Cornell School of Medicine, named for its financial patron Sandy Weill, former CitiGroup executive, is focusing priority research on “precision medicine”—the polite name for individual gene-profiling and custom-treatment for the elite. If you can pay, you can live.

7. IPAB—CUT LIVES, TO CUT COSTS, BY DECREE. The Independent Payment Advisory Board (IPAB) was authorized in 2010 under the ACA, in sections 3403 and 10320. Its purpose is to formulate specific cuts to medical care, mostly for those on Medicare—the old, in order to save money. Because of its infamous mandate, its 15 member board, which must be approved by the Senate, has not even been appointed so far. Unprecedented power is designated for IPAB, which is scheduled to go into effect in 2014. While the law is written to say that IPAB will not cut care according to costs, it will simply accomplish the same objective through application of the criterion of statistical “effectiveness,” and financial benchmarks. The Medicare program is under orders to implement whatever IPAB orders, unless those cuts are expressly overruled by a vote in Congress, which must be through a super-majority.
IPAB is modeled exactly on the 1999 agency created under the Tony Blair government, NICE (National Institute for Health and Clinical Excellence), which has ordered cuts in treatment by the National Health System of Britain, resulting in a record of increased death rates since then.

8. SIGN-UP PRETENSE. After only two weeks into the operation of the new online markets of obtaining insurance, the drastic malfunctioning of the system, the rate of non-signups, and most of all—the fact that 5 to 9 millions of people are known in advance to be disqualified for coverage—manifest how the process is a pretense.
The “disqualified” status hits those poor persons, who make too little annual income to qualify for a Federal subsidy on an insurance policy from the exchange—specifically, less than 138% of the official poverty line; and too much money, to qualify to enroll in Medicaid, relative to the poverty line rules in their state.
These people reside mostly in the 26 states, 17 of which are in the South, where Medicaid has not been expanded under inducement of Federal financial incentives upfront, which are to be then cut back in three years. Both the White House and the respective state Congressional leaders have known all along about these categories of people, considered “unqualified” for arrangements for medical care.
Two national estimates have been done on how many people are in this category nationwide, based on census data, plus Obamacare and Medicaid rules:
A New York Times Oct. 2 report, titled, “Millions of Poor Are Left Uncovered by Health Law,” estimates that nearly nine million are in a “gap” preventing them from any insurance. Obamacare “will leave out two-thirds of the poor blacks and single mothers, and more than half of the low-wage workers who do not have insurance…” (by S. Tavernise and R. Gebeloff).
A report Oct. 17 by the Kaiser Commission on Medicaid and the Uninsured, puts the national figure at 5.2 million Americans denied health insurance coverage. The study reports:

* Texas. More than 1 million people won’t have access to insurance.

* Florida. 763,890 won’t get insurance. Also large numbers of uninsured under Obamacare are in Alabama, Louisiana, Mississippi and South Carolina.

* Tennessee. Up to 220,000 won’t get insurance.

On the technical dysfunction of the exchanges, details are provided in the Oct. 12 New York Times report titled, “From the Start, Signs of Trouble at Health Portal.” A research team (R. Pear, S. LaFranier, and I. Austen) summarized the analyses of many IT experts. The conclusion, “‘These are not glitches,’ said an insurance executive who has participated in many conference calls on the federal exchange…Interviews with two dozen contractors, current and former government officials, insurance executives, and consumer advocates, as well as an examination of confidential administration documents, point to a series of missteps — financial, technical and managerial — that led to the troubles.” In other words, planned failure is the name of the game. As the Times noted, “just a trickle of the 14.6 million people who have visited the federal exchange so far, have managed to enrol in insurance plans….” The Obama Administration refuses to say how many.

9. PENALIZE TRADE UNION INSURANCE PLANS. Trade union members covered by multi-employer plans—referred to as the Taft-Harley plans—are considered by the ACA as high-end insurance-policy holders, and as a class, ineligible for usage and benefit from the new exchanges. An estimated 26 million U.S. workers fall into this group, according to the National Coordinating Committee for Multi-employer Plans.
Additionally, in 2018 these types of insurance plans, among those considered “Cadillac plans,” are subject to a large new Obamacare tax.

10. BACK COMPANIES TO CUT WORKFORCE. Many companies and local government entities are cutting hours of employees to below 30 hours per week, to avoid the ACA mandate for providing coverage for all “full-time” employees, and making other kinds of downshifts. For example, Trader Joe’s and Home Depot are shifting part-time workers to the Obamacare exchanges.
Smaller companies are socked by the “Employer Shared Responsibility Payment” Obamacare mandate, which, under pressure, was postponed a year to 2015.

11. COST SHOCK. Insurance premium prices on exchanges vary by state, but cost shock is hitting online shoppers cross country for various types of policies. For example, in some states, rates for large and small companies, which already have gone up an average of over 20% a year for the last three years, will now jump as much as 40% the first year (2014). These costs will be passed on to their workers.

12. INSURANCE SUBSIDIES TO WALL STREET. Under Obamacare, the insurance mandate constitutes unprecedented flows to the insurance wing of the Wall Stree/London financial crowd. Dimensions of the matter are reported in Forbes, Oct. 1 (Robert Lenzer), noting that the “value of the S&P health insurance index has gained 43% this year alone.” Among the major companies, CIGNA is up 63%, Wellpoint 47%, and United Healthcare 28%. Since the passage of Obamacare in 2010, the stock values of these big firms have risen 200-300%.
– IV. WHAT MUST BE DONE –

1. The first step is to repeal the 2010 Patient Protection and Affordable Care Act. This must taken in the course of Congressional action to restore the Glass-Steagall Act of 1933, as the gateway for stopping the Wall Street crash process, and issuance of credits to rebuild the economy.
Glass-Steagall re-instatement bills are in both chambers of Congress: In the House of Representatives, HR 129 (The Return to Prudent Banking Act of 2013 ), with 75 co-sponsors, which is in the Senate as S.985 (Return to Prudent Banking Act of 2013), filed by Tom Harkin (D-Iowa); and S. 1282 (21st Century Glass-Steagall Act of 2013), filed by by Elizabeth Warren (D-Mass.), with nine co-sponsors.
Bills to repeal the ACA have been passed repeatedly in the House of Representatives. With passage in the Senate, the corollary measures outlined below can proceed.

2. Initiate impeachment proceedings to remove Barack Obama from office, for the crimes inherent and on record, from the ACA and his conduct in office.

3. Declare a moratorium on closures of hospitals, clinics, radiology centers, doctors practices, public health and research laboratories, and other vital parts of the health care delivery system, pending review, and initiation of a new program to build up health care delivery capacity to modern standards for all Americans.

4. Affirm and implement the priniciples embodied in the Hill Burton Act (Hospital Survey and Reconstruction Act of 1948), 42 U.S.C. 291 et seq., as the governing principles for U.S. health care policy.

5. Launch new research initiatives for advanced medical, biological and chemical research, in conjunction with a renewed drive for a nuclear fission-based economy, and soon, nuclear-fusion economic platform.

6. Activate anti-trust action throughout the health care sectors, in which facilities and services have been taken over and dominated by extensions of Wall Street operations in pharmaceuticals, hospital care, group practices of physicians, research, and other matters.
In particular, cancel the 1973 Health Maintenance Organization authorization law, and nullify subsequent laws to the same effect. This means, repeal 42 U.S.C. Section 300c, et seq.

7. Examine and act on the best way to provide health care for all Americans, under the principle of the clause in the Preamble to the Constitution, “to promote the General Welfare.”

The “Medicare for All” act in Congress, is the current foremost proposal to cut Wall Street out of looting health care and dictating death. It calls for instituting an insurance coverage system (called “single payer”)—different from that which worked in the pre-1970s/HMO period—but still aimed at seeing everyone gets treated. Those under age 65 would be eligible for Medicare coverage; premiums and practices would be set accordingly.
In recent years, Medicare’s overhead costs amount to only 3% of its expenditures, in contrast to what has been 30% overhead under the Wall Street HMO insurance system, and the fake mandate under Obamacare, which asks insurers to limit overhead to 20%.
Rep. John Conyers (D-Mich.) has a bill (HR 676—”Expanded and Improved Medicare for All Act”) in the current session of Congress, with 51 co-sponsors.” http://larouchepac.com/node/28620

” United Healthcare, the largest insurer, with about 70 million insured, reported last summer that they had a particularly strong past year, with net income of $5.1 billion, up by 11% from the previous year; similarly for the others — even before the bonanza to result from the corporatist plan to force every American to buy their inflated products, beginning on October 1.
United Healthcare, it should be recalled, has as a top executive Simon Stevens, who was Tony Blair’s health policy advisor and the architect of NICE (National Institute for Health and Clinical Excellence) in 1999, the “reform” of the British National Health Service which imposed triage and genocide on the British people through selective denial of cancer drugs, surgeries, kidney dialysis, and other treatments. This was the model for the IPAB (Independent Payment Advisory Board), which is now the law of the land under Obamacare. Genocide can be profitable. ” http://larouchepac.com/node/28409
( Obamacare Genocide in Action: What is Already Underway http://larouchepac.com/node/28608 )

” Obama’s Budget Argument for Killing People: Meet the Elephant in the Living Room

If you are fed up with all the arguments for justifying genocidal budget cuts coming from Obama and his Democrats, as well as the Republicans, consider the following. After the orchestrated government shutdown and debt ceiling crisis, the American population is now being told we have no choice but to swallow a national discussion of how to go about:

* Cutting some $100 billion per year in health expenditures via Obamacare, by wiping millions from the rolls of the insured, reducing payments to hospitals and other providers, and denying care to the elderly and sick whose lives are “not worthy of being lived”—just as Hitler did under the T-4 policy;
* Eliminating $140 billion per year through the “sequester,” half from defense expenditures and half from other budgetary items; and
* Chopping another $95 billion per year from Social Security and other entitlements, through such ruses as the so-called chained CPI.

Those items alone add up to some $335 billion per year in cuts whose predictable—and intended—effect will be genocide. And yet the Federal Reserve is bailing out the bankrupt Wall Street banking system to the tune of $1 trillion per year in Quantitative Easing. That’s three times what we are told we have to cut from the flesh and blood of our people and our productive economy! Not to mention the much larger speculative bubble of worthless international financial assets, which now totals some $1.6 quadrillion, which the British Empire says has to be saved no matter how many billion humans are killed in the process.
And yet when Lyndon LaRouche says we should stop the bailout of Wall Street, and reorganize the banking system based on the Glass-Steagall standard, people holler that he’s “over the top.” The only thing that’s “over the top” here is the damned elephant sitting in the living room. Get rid of him. ” http://larouchepac.com/node/28622